Membership Application for the Second Battalion, 4th Marines Association, Inc.   (A Not-for-Profit Association)

 

Your information will be included in the Published Roster on the 2/4 web page; only names, dates of service and unit information will be published.  For security, your home, work information, including phone numbers and email address…will not be listed.   This information will only be made available through the Roster Manager of the Association unless you initial here for this information to be passed out upon request________.  We ask for a nickname if applicable because it does make it easier for those of us that are memory challenged, some of us can only remember a person by “Juicy” or “Magnet Ass” or even worse.

 

Name: First ______________________________ MI: ______Last: ______________________________

 

Phone #: (_____)_____--_____________________ Work #: (____)______--_____________________

 

Email address: ______________________________Nickname known by: __________________________

 

Address:_______________________________________________________________________________

 

City:___________________________________ State:__________ Zip Code + 4: ____________--_______

 

Rank: current/separation ___________________ Present status:  Separated ______ Active Duty ______

 

Period of Service with 2/4: (From)____/____/____     (To)____/____/____

 

Unit assigned during tour with 2/4 (inc. Platoon & Co.): __________________________________________

 

Personal Awards/Decorations:_______________________________________________________________

_________________________________________________________________________________________

*****Optional Information*****

Name of Spouse or Significant other :__________________________________________________________

Children's Names: _________________________________________________________________________

High School: ________________________________ College: ____________________________ Degree ___

Current Occupation:________________________________________________________________________

Employer:________________________________________________________________________________

Hobbies/Interests:__________________________________________________________________________

Personal Achievements:
(Books, Articles, etc)________________________________________________________________________

(Civil Service) _____________________________________________________________________________

(Elected Official)___________________________________________________________________________

(Notable Feats) ____________________________________________________________________________

 

The Association is run totally on its member’s dues and a few fund raising events.  Because of this, we must ask for a paid membership. If there are circumstances that you cannot afford the dues or if you wish to support others by donating to our dues fund please contact the current Association President at: President@2ndbn4thmarine.com 

 

*****Dues Information*****

Note: Print this form and mail it with your check.

No information will be released to anyone outside the Association under any circumstances.

 

Life Memberships: Life Membership dues can now be paid in 3 installments over a time period not to exceed

 9 (nine) consecutive calendar months.

                                             

 

 

Annual Membership runs from July 1st through June 30th

 

 

 

 It will be all the members' reasonability to schedule the payments, as the Association lacks the funds and manpower to send out past due notices.  If you fail to complete payment of the life membership dues, any sums paid towards it will be converted and credited as Annual Membership dues.

Make Checks or Money Orders payable to:

 

2/4 Association

c/o Jim Mazy

6122 Shasta Street

Englewood FL 34224

 

AssocRosters@www.2ndbn4thmarines.com